The African proverb, “It takes a village to raise a child,” could be adapted to clinical trials in New Mexico. Just as it takes many people to raise a healthy child, it takes many health care organizations to collaboratively offer cancer clinical trials across the state of New Mexico.
For nearly 20 years, the New Mexico Cancer Care Alliance (NMCCA) ensured that New Mexicans in all parts of the state had access to cancer clinical trials. That network of health care organizations has modernized its processes. It also strengthened its focus and mission on delivering clinical trials and clinical research to prevent, detect, and treat cancer and to improve patient outcomes, experiences and access to cancer care using culturally sensitive approaches.
The rebranded organization, now called the New Mexico Cancer Research Alliance (NMCRA), held its first in-person scientific retreat on June 21. Attendees at the event represented The University of New Mexico Comprehensive Cancer Center, Presbyterian Healthcare Services, Lovelace Health System and Memorial Medical Center and the Veteran’s Administration Hospital System.
Summary
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The New Mexico Cancer Care Alliance (NMCCA) has rebranded as the New Mexico Cancer Research Alliance (NMCRA) to strengthen its focus on delivering cancer clinical trials to New Mexicans.
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Through the NMCRA’s unique collaboration, every New Mexican has access to cancer clinical trials.
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Cancer clinical trials test new treatments and new methods of delivering and improving cancer care
A “Gem” to Improve Cancer Care
The NMCRA is an incredible gem for the people of New Mexico,” says Carolyn Muller, MD, FACOG, NMCRA Director. “Clinical research improves the lives of cancer patients by focusing on better ways to prevent, detect and treat cancer and to optimally deliver cancer care.”
Cancer Clinical research is conducted through clinical trials, which test new treatments and new methods of delivering and improving cancer care. Some trials test whether new drugs are more efficacious than the currently used “standard” drugs. Some test new drug combinations.
Other cancer clinical trials test better ways to screen for cancer or lessen symptoms from cancer or cancer treatments. Still other trials test different methods of delivering care to different people, such as individuals from different racial or ethnic communities or those who live in rural or underserved communities.
The United States Food and Drug Administration (FDA) oversees all clinical trials in the US. It ensures that all clinical trials are conducted safely and with the full understanding and consent of those who choose to take part in them. It also ensures that clinical trials are “designed, conducted, analyzed and reported according to federal law and good clinical practice (GCP) regulations.”
The FDA enforces a four-phase process of testing through which new treatments are approved for use. Each phase has its own set of requirements that treatments must meet in order to progress to the next phase.
Professional medical organizations, such as the American Society for Clinical Oncology (ASCO) and the National Comprehensive Cancer Network (NCCN) create guidelines for cancer related clinical practice based on the strength of scientific evidence that results from clinical trials. These standards reflect the latest scientific research and best-known practices for delivering care.
The current standard treatments and care practices in effect today went through scientifically rigorous clinical trials to become the standards. When new clinical trials show a drug, treatment or method to be more effective than the current standard, the practice of cancer care changes.
Muller says that the results of several practice-changing clinical trials were presented at the most recent American Society for Clinical Oncology (ASCO) national conference. Some New Mexico patients took part in those clinical trials.
“Our patients had an opportunity to benefit from the clinical trial treatments, and they also helped future patients receive better care,” says Muller. “They are true heroes!”
“Cancer research is the key to progress in our battle against cancer,” says Dr. Heyoung McBride, MD from Lovelace Cancer Center, Radiation Oncology. “It is only through high quality research that we can advance our understanding of biological processes involved in cancer and improve outcomes for patients and loved ones suffering from cancer,” she says.
Daunting Challenges
New Mexico’s small population is spread over a large area: the state ranks fifth in land mass but 36th in population. Offering clinical trials to people throughout the state thus presents a daunting challenge.
Because of their scientific nature, clinical trials demand more than strict adherence to a detailed plan, called a protocol, that every person on the trial must follow. Trials also require evidence that each person has followed that protocol. Should anyone deviate from the protocol – for example, if someone must come off the protocol because of a new health issue or a serious side effect – a note of that situation must also be recorded and reported, especially for safety purposes.
A cadre of expertly-trained research teams are needed to manage clinical trials. Some of these people are trained to ensure that participants in each clinical trial meet all the criteria for joining that trial. Others explain the protocols to potential participants. And many others enter clinical trial data, manage databases, report results to oversight entities, and track patient responses and side effects.
Few, if any, independent doctor’s offices could manage clinical trials on their own. Even some larger health care organizations in the state would struggle under the vast administrative burden. UNM, as the only NCI designated Comprehensive Cancer Center in NM, serves as the academic hub for the NMCRA. And the NMCRA brings cutting edge clinical trials and clinical research from the National Cancer Institute, lead investigators and other stakeholders to the NMCRA member health systems.
Through the NMCRA’s unique collaboration, UNM’s clinical research expertise is shared with all affiliated cancer treatment providers in the state. The UNM Cancer Center’s Clinical Research Office supports many of the core functions of the NMCRA.
This collaborative effort between the academic and community health systems partners has led to sustained funding support from the National Cancer Institute’s National Community Oncology Research Program (NCORP).
“The NCORP Program delivers state-of-the-art national cooperative group clinical treatment, prevention and screening trials to New Mexico,” Muller says. She also notes that many clinical research leaders in New Mexico across the NMCRA not only serve on the national committees that help to shape the future of these trials but also make sure that New Mexicans can access these trials.
“Health systems in New Mexico value cancer clinical trials,” says Muller.
William Adler, MD, at Memorial Medical Center in Las Cruces, sees the benefits of clinical trials for New Mexicans, He says, “Memorial Cancer Center has made clinical research trials a priority for nearly 15 years. The availability of these national and international studies allows patients to stay at home with their families and still have access to the leading edge of cancer care. The cancer program at Memorial Medical Center has received national recognition for its clinical trial research activities. As the umbrella organization, NMCRA has made cancer clinical research possible in southern New Mexico.”
Malcom Purdy, MD, at Lovelace Cancer Center Medical Oncology agrees. He says, “The Lovelace Cancer Center has participated in clinical trials with the University of New Mexico for close to 40 years. These have included groundbreaking studies which have advanced patient care and cancer treatment, especially in breast cancer. Unlike clinical trials for other conditions, clinical trials for cancer patients take the best of what we know now and add to that care, so all participants receive excellent care. I always tell my patients that participation in a clinical trial gives the best care.
Access for All
As the many affiliates of the NMCRA know, offering the best cancer care isn’t good enough; that care must reach the people who need it.
In addition to the large cancer care providers, smaller oncology practices throughout the state are also NMCRA affiliates. They provide cancer clinical trials to people in some of the most underserved and remote areas in New Mexico.
And the National Cancer Institute (NCI) also recognizes the need to bring cancer care and cancer research to people who have not taken part in clinical trials in the past or who may face significant barriers to joining then now.
Through the NCORP grants, the NCI has created “a national network that brings cancer clinical trials and care delivery studies to people in their own communities.” The UNM Cancer Center is one of the Minority/Underserved NCORP sites, and NCI cancer clinical trials are delivered through the NMCRA
The NCI is also focusing on cancer care delivery. Cancer care delivery research studies how different processes, models, concepts and approaches can improve the quality of cancer care, patient outcomes, and access to care.
Chandylen Nightingale, PhD, MPH, Assistant Professor in the Department of Social Sciences and Health Policy, Division of Public Health Sciences, at Wake Forest University School of Medicine spoke at the recent NMCRA scientific retreat and shared her research and insights and the importance of cancer care delivery research.
“It is imperative for New Mexico’s cancer patients to have access to innovative treatments that will hopefully move cancer care forward,” says Ethan Binder, MD, at Presbyterian Healthcare Services Hematology/Oncology. “The NMRCA is a wonderful collaborative effort that truly tailors cancer research for New Mexicans.”
The University of New Mexico Comprehensive Cancer Center is the Official Cancer Center of New Mexico and the only National Cancer Institute-designated Cancer Center in a 500-mile radius. Its more than 120 board-certified oncology specialty physicians include cancer surgeons in every specialty (abdominal, thoracic, bone and soft tissue, neurosurgery, genitourinary, gynecology, and head and neck cancers), adult and pediatric hematologists/medical oncologists, gynecologic oncologists, and radiation oncologists. They, along with more than 600 other cancer healthcare professionals (nurses, pharmacists, nutritionists, navigators, psychologists and social workers), provide treatment to 65% of New Mexico’s cancer patients from all across the state and partner with community health systems statewide to provide cancer care closer to home. They treated approximately 14,000 patients in about 100,000 ambulatory clinic visits in addition to in-patient hospitalizations at UNM Hospital. A total of nearly 400 patients participated in cancer clinical trials testing new cancer treatments that include tests of novel cancer prevention strategies and cancer genome sequencing. The more than 100 cancer research scientists affiliated with the UNMCCC were awarded $35.7 million in federal and private grants and contracts for cancer research projects. Since 2015, they have published nearly 1000 manuscripts, and promoting economic development, they filed 136 new patents and launched 10 new biotechnology start-up companies. Finally, the physicians, scientists and staff have provided education and training experiences to more than 500 high school, undergraduate, graduate, and postdoctoral fellowship students in cancer research and cancer health care delivery. Visit www.UNMHealth.org/cancer.
Presbyterian Healthcare Services exists to improve the health of patients, members and the communities we serve. Presbyterian is a locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, it is the state’s largest private employer with more than 13,000 employees.
Lovelace Health System (Lovelace) recently celebrated its 100th anniversary, marking a century of caring, change and progress while continuously improving the practice of medicine.
Lovelace is comprised of Lovelace Medical Group/New Mexico Heart Institute, Lovelace Women’s Hospital, Lovelace Medical Center, Heart Hospital of New Mexico at Lovelace Medical Center, Lovelace Westside Hospital, Lovelace Regional Hospital and Lovelace UNM Rehabilitation Hospital. Across its six hospitals, 33 health care clinics and seven outpatient therapy clinics, Lovelace has 619 inpatient beds and employs a team of more than 3,450, including over 280 health care providers. Lovelace continues to invest in our community, providing more than $81 million in unfunded care and supporting local nonprofit and community organizations with more than $357,000 in charitable contributions and community support in 2022. From the first and only hospital in New Mexico dedicated to women’s health to the state’s only hospital devoted exclusively to cardiovascular care, Lovelace is a leader in meeting the healthcare needs of this region. To learn more about our state-of-the-art treatment options, innovative health care providers and award-winning quality initiatives, visit lovelace.com.
Memorial Medical Center is a 199-bed full-service acute care hospital located in Las Cruces, New Mexico and serving a five-county region of Southern New Mexico. Our mission is simple: Making Communities Healthier. We are a part of the LifePoint Health family of hospitals, which means we aim to create a place where people choose to come for healthcare, physicians and providers want to practice, and employees want to work. Learn more at mmclc.org.